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Medical Forum / Diseases and Disorders / Prostate Cancer / November 2005PSA "Noise"
There are a lot of people posting here regarding PSA levels with resolutions equal to or less than 0.01. My urologist and oncologist both agree that, quantitatively speaking, absolute readings below 0.1 are relatively meaningless, They are "in the noise" so to speak (no matter what resolution test is used). I asked why, of course... A: Prostate cells are not the only ones that produce PSA. Other contributors may be present and signficant below levels of 0.1 A: All prostate cells, malignant or not, produce PSA. Malignant cells simply produce more. At these low levels there is really no way to differentiate, and that's assuming that there are really prostate cells present. A: Many psychological and physiological factors contribute to PSA level variations, usually swamping resolutions below 0.1 (even in patients treated with RP or radiation) They were both quick to say that confirmed precision readings may be qualitatively significant (things like PSA acceleration and doubling times) but must be combined with significant absolute readings (above 0.1 for post therapy patients and above 0.4 for pre-therapy patients) before any further diagnostic/curative action should be contemplated. Of course there are exception even to these "rules" (like an abnormal DRE or significant symptoms). Anywho, I'm due for my next PSA test, three months after the last and 10 months after LRP. My initial post-op PSA test were cause for concern. Taken at monthly intervals beginning 3 months after surgery they were 0.24, undetectable, 0.12, undetectable, udetectable. I am of course concerned.... concerned enough to put off making winter vacation reservations until after the PSA test for fear that readings above 0.1 would trigger further regular tests and prep for EBRT (and of course my max out-of-pocket resets Jan 1). I've also quietly watched developments in this NG regarding the use of hormonal therapies. It is my understanding that the only possible "curative" treatments are surgery and radiation. It is my understanding that hormonal therapy is a "slow down the beast" treatment, that it will eventually become ineffective and that there may be significant SE's. If that is the case then EBRT is my last "silver bullet", one that I want to fire at exactly the right time. Further, since HT is not curative and has a finite "half-life", if and when the EBRT proves not to have worked, I will wait until the last possible monent before Invoking HT, if at all. Can anyone here comment on the "PSA noise" issue, and/or on my diatribe regarding post LRP treatment? To all of you, who have been my salvation through this whole horrible experience, have the happiest of possible Turkey Days, and may it find you and yours healthy, safe and warm! When I was diagnosed in April 2003 I did a lot of reading on the subject, so at this point I cannot remember where I read this. But, as I recall, the adrenal gland produces PSA also. I have never read anything that indicates the significance or measurability of the PSA produced by the adrenal gland, but it would seem to me that it could be a factor in the ultra sensitive tests. Of course, women have adrenal glands, so in that case they too can have PSA. Or so I read 2+ years ago. Anyone else familiar with this? > There are a lot of people posting here regarding PSA levels with > resolutions equal to or less than 0.01. [quoted text clipped - 52 lines] > experience, have the happiest of possible Turkey Days, and may it find > you and yours healthy, safe and warm! Buttercup's Dad wrote...snip... > as I recall, the > adrenal gland produces PSA also. I have never read anything that indicates > the significance or measurability of the PSA produced by the adrenal gland, > but it would seem to me that it could be a factor in the ultra sensitive > tests. Of course, women have adrenal glands, so in that case they too can > have PSA. Or so I read 2+ years ago. Anyone else familiar with this? That's right, some other organs in the body produce very small amounts of PSA. For example, psa has been found to be present in very low levels in pituitary tissue and adrenal tissue. It is found in many tumors (e.g. lung). It has also been found in women (breast and ovarian tissue). PSA in women can occasionally exceed 0.1 ng/ml depending upon BCa status, age, time in the menstrual cycle, etc...Best wishes and good health, Ron What I remember reading is that the adrenal glands produce testosterone -- not PSA. But then again, that's just from memory : ) > When I was diagnosed in April 2003 I did a lot of reading on the subject, > so [quoted text clipped - 6 lines] > tests. Of course, women have adrenal glands, so in that case they too can > have PSA. Or so I read 2+ years ago. Anyone else familiar with this? > I am of course concerned.... concerned enough to put off making winter > vacation reservations until after the PSA test for fear that readings > above 0.1 would trigger further regular tests and prep for EBRT (and of > course my max out-of-pocket resets Jan 1). I'm not putting my life on hold for ANYTHING diapers or Tylenol will solve. PC's not going anywhere in the span of one lousy vacation, and I've got only 10-15 years left anyway unless I blow the statistics out of the water. IOW, your PC will never know you took that vacation, but YOU will certainly know if you abandon it. Who's more important . . . YOU, or your PC? > It is my understanding that the only possible "curative" treatments > are surgery and radiation. It is my understanding > that hormonal therapy is a "slow down the beast" treatment, that it > will eventually become ineffective and that there may be significant > SE's. If that is the case . . . If you're still at the "understanding" (i.e., not certain) stage, you haven't done enough research to make decisions regarding adjuvant treatment. The "understandings" you present here are certain, with one exception: ADT (aka HT) virtually WILL, not "may", produce significant SEs, according to trials, authors, and a poll of this forum. The odds of escaping them are extremely low . . . down in that noise. > then EBRT is my last "silver bullet" Yup. > one I want to fire at exactly the right time. IF one is going to fire it, isn't the best time NOW, before the PC can spread any more? I'd think (and I've not researched this yet because my PSA is definitely in the noise) the real question is the IF, not the timing. > I will wait until the last possible moment before invoking HT, if at all. You and me both. The therapeutic ratio statistics, and many patients and authors, don't support anything else, IMO, BASED ON MY PERSONAL PRIORITIES. > To all of you, who have been my salvation through this whole horrible > experience I'm sorry to hear your experience was horrible. Mine has merely been a couple weeks of major discomfort, a lingering minor nuisance, the wasted expense of a huge pile of new boxer shorts (they were on sale) I'll apparently now never use, and being reminded that I'm not invincible. The REAL impact has been the man-months of time spent on the research, but that, in turn, has freed me from doubts about my treatment choices, so it wasn't wasted. What's relatively horrible to me -- and I'm not joking -- is that my windsurfing season has probably ended, and I haven't found a place worth traveling to for a whole winter of good windsurfing. I'll reserve the "H" word for when I hit intractable clinical failure and am forced to choose between different unacceptable alternatives. I.P. On November 16, I. P. Freely wrote, in pertinent part: > ADT (aka HT) virtually WILL, not "may", produce significant SEs, according to > trials, authors, and a poll of this forum. The odds of escaping them are > extremely low . . . down in that noise. What IP consistently and inexplicably fails to report in his tales of horror is what can be done to alleviate any SEs that may be experienced. And, as I keep posting again and again, not all men experience all, most or any of the possible SEs. Since IP knows this, I have to wonder about his motivation in posting again and again his dire warnings about things that may or may not occur. Regards, Steve J "I am under no obligation to respect your beliefs. Respect is earned; it is not an entitlement..." -- Lionel Shriver > > then EBRT is my last "silver bullet" > [quoted text clipped - 28 lines] > > I.P. > What IP consistently and inexplicably fails to report in his tales of > horror is what can be done to alleviate any SEs that may be experienced. [quoted text clipped - 3 lines] > Since IP knows this, I have to wonder about his motivation in posting > again and again his dire warnings about things that may or may not occur. My motivation is the same as that of the authors and studies, especially Strum, whose dire warnings I parrot: to make more patients and doctors aware of the various severities and frequencies of SEs. And as I have posted every time Steve says "not every pt gets every SE" is "of course not", but the literature states repeatedly in various ways that almost every ADT pt will suffer at least one of the truly bad SEs or at least a bad combination of the lesser ones. I also point out evvvveeery time, for the sake of those who haven't beaten this horse with us before, that the anti-SE meds have their own suite of SEs, which in turn need further meds with THEIR own SEs, ad nauseum. IMO, the only people who needn't research SEs very heavily before making treatment decisions are those who value a heartbeat not just MORE than QOL, but REGARDLESS of QOL, as some have stated here. Most people here revere Strum, so it's unclear to me what motivates Steve to constantly reject Strum's work. I'm sure many of us would like to know why, so we can make informed decisions on whether or when to doubt Strum. I.P. I am not sure which of your posts to Brian I should answer.....but what you are missing in this equation is that in a lot of cases, hormone therapy (ADT) is the ONLY choice that some of us (my husband for instance) have!! Nor do I know what you are referring to as "truly bad SE's". Ron has some debilitating ones at the moment, but we are working on that. Nor do I know which medications taken to alleviate which SE's are truly bad. Ron was on Megace for night sweats and it worked and he had no side effects. He has now stopped it and is finding the night sweats seem to have disappeared. He was offered Effexor but has no interest in taking an SSRI drug. (derivative of Prozac) In essence....he prefers "life" over QOL. The alternative is not something most men would choose. I still don't know why you would prefer QOL over life (or heart beat as you call it), but we all make our own choices. And Ron prefers to live as long as he can, knowing that ADT is holding the cancer at bay. We did see our original rad onc last week and I will let you know how it all went......but I just had to say that you can't possibly know what ADT patients go thru because you don't take it. Every one of those that take it have different reactions. Good and bad. But they have something more precious....a few more years on this planet. THAT is my point!! We seem to be at opposite ends of the spectrum on this. But to each his own....just don't scare the hell out of newbies with your dire predictions!! Let them decide, in conjunction with their oncologist, if living is more important than possible side effects. And this was not a slam at you....it is called "balancing your views versus those of us who have no choice". Heather >> What IP consistently and inexplicably fails to report in his tales of >> horror is what can be done to alleviate any SEs that may be experienced. [quoted text clipped - 23 lines] > > I.P. I don't see how anyone could put this better. Right now I am off treatment (and, who knows?, may stay that way) but if I have to go back to ADT, that will be my choice, without question. .The choice is Life. I did have SE's when I was on ADT, and I didn't like them, but they certainly weren't so bad that I'd rather be dead. Nothing like that. And we owe it to our families to stick around as long as we can. >I am not sure which of your posts to Brian I should answer.....but what you >are missing in this equation is that in a lot of cases, hormone therapy [quoted text clipped - 59 lines] >> >> I.P. Thank you Stavros, and Thank you Heather, Your responces are dead on. There are a great many of us for whom ADT is not only, a viable treatment, but a necessary treatment. And yes, the SE's suck. In my case, they have kept me from working full time (construction electrician). But the ADT has certainly not kept me from enjoying life, and will probably keep me around long enough to watch the grandkids grow up. Each treatment for PCa has its own set of attendant SE's. All you need do is follow this NG for a while, to realize that no matter which path you follow, you'll never be the same as you were prior to treatment. The SE's of ADT are certainly no worse than some of the SE's following RP or RT that have been mentioned here. Can't recall anyone needing a sling, sphincter or penile implant due to ADT. Dan  SignaturePSA = 2.2 , 03/05/2003 PSA = 7.92, 09/30/2004, @ 54 Biopsy, 11/10/2004, G9(5+4) (multiple cores) (6 of 8 cores positive), T1C EBRT, 01-03/2005 @55 Casodex (daily), begin. 11/16/2004 Zoladex, 12/23/2004, 03/10/2005, 06/14/2005, 09/14/2005 PSA, 0.1, <0.1, <0.1 "dan" <wrote > The SE's of ADT are certainly no worse than some of the SE's following RP > or RT that have been mentioned here. Can't recall anyone needing a sling, > sphincter or penile implant due to ADT A highly personal evalutaion. I've never seen anyone say they'd rather take their chances with PC than get a sling or an implant, but MANY individuals have chosen fate, some even certain death, after trying ADT, and large studies reinforce that. Additionally, RT and RP can cure; ADT cannot. I.P. > we owe it to our families to stick around as long as we can. Where do we draw that line? Months of screaming, intractable pain wiping out every other thought? Years of total dementia with Alzheimers? Terri Schiavo? My family deserves neither horrible fate. I.P. I don't get you. ADT causes none of that. ADT holds back PCa and it is the PCa that causes those horrors. The issue here is the choice between NOT having the PCa horrors and being able to get on with life with possible SE's that do not prevent us from enjoying it and having advanced PCa soon. That is the issue: whether ADT is worth the SE's. It sure is. Now, you raise another serious question--but it is a different one--whether life is worth living with advanced, symptomatic PCa and, as you put it, "screaming pain." For one thing, I am not sure that it is a question we should be troubling those of us here who are not at all in such a condition or may ever be (we have had testimony here of those who have died a quite peaceful death from PCa). But mainly it is a personal religious or philosophical. if you will, question, not a medical one, a question each of us will answer, if it ever comes to that, according to our values and beliefs. We all of us here respect each other's beliefs and do not try to impose them on others. >> we owe it to our families to stick around as long as we can. > [quoted text clipped - 3 lines] > > I.P. >I don't get you. ADT causes none of that. My comments clearly and specifically referred to your "we owe it to our families to stick around as long as we can", with no reference to ADT effects. > The issue here is the choice between NOT having the PCa horrors and being > able to get on with life with possible SE's that do not prevent us from > enjoying it > That is the issue: whether ADT is worth the SE's. It sure is. Tell that to the countless pts whose ADT SEs were so severe they dropped ADT and chose fate, even death, instead. And I don't consider SE odds like 70%, 90%, >99%, and "certain" to be commensurate with "possible", nor do I consider "debilitating" as compatible with "do not prevent us from enjoying [life]". > Now, you raise another serious question--but it is a different > one--whether life is worth living with advanced, symptomatic PCa and, as > you put it, "screaming pain." For one thing, I am not sure that it is a > question we should be troubling those of us here I don't believe in avoiding tough, relevant issues. If I did, I'd have skipped that nasty ol' surgery and enjoyed a few more of sex and clean shorts. > But mainly it is a personal religious or philosophical. if you will, > question, not a medical one Absolutely wrong when we're dying without a living will and advanced directive, generated only by diving deeply into our psyches and codifying our conclusions in a legal, notarized, binding, widely disseminated document while we're still of sound mind. No family -- well, very few, and probably not Schiavo's parents -- deserve the nightmares that omission can cause. > We all of us here respect each other's beliefs and do not try to impose > them on others. That's why I impose nothing, and why I speak out when others do try to impose theirs. I offer facts and opinions, and try very hard to identify each as such. I.P. There's no need for "screaming, intractable pain" as long as morphine is around. I had a colleague die of PCa and he spent the last two months doped up in a near comatose state. He didn't complain and he wasn't screaming either. Another acquaintance also with PCa worked right up to the last day when he called in sick saying he wasn't feeling well. He died about 10 hours later. My gripe is with our archaic drug and assisted suicide laws or lack of same. Reducing two months of near comatose keeping-a-bed-warm down to a couple of hours would save a hell of a lot of money and a whole hell of a lot of grief for all involved. The only reason I can find to keep someone alive under these circumstances is to delay death until after midnight, December 31 so that the surviving spouse can get another year of "Married, Filing Joint." Dave Perry <judamd@aol.com> wrote... > There's no need for "screaming, intractable pain" as long as morphine > is around. Right, but many here and nationwide also say that even the comatose period which follows when the only alternative to screaming pain is morphine-induced coma is better than death, and doctors are required by law, in the absence of a legal document to the contrary, to act that way. Many do so even in the PRESENCE of such a document. I can even imagine a world so insane that the SUPREME COURT and the CONGRESS should get involved in dragging out a brain-death-induced coma for over a DECADE. But SURELY no U.S. Attorney General would EVER get so damned uppity that he would try to tell a state it must abolish an assisted suicide law. (I'd put a smiley here if this weren't such a grave issue.) I.P. I had a colleague die of PCa and he spent the last two > months doped up in a near comatose state. He didn't complain and he > wasn't screaming either. Another acquaintance also with PCa worked [quoted text clipped - 8 lines] > "Married, Filing Joint." > Dave Perry > And we owe it to our families > to stick around as long as we can. That depends on how much life insurance we have. "Heather" wrote... > Nor do I know what you are referring to as "truly bad SE's". Some SEs are obviously and non-debatably bad, others highly subject to personal choices, others just nuisances. > Nor do I know which medications taken to alleviate which SE's are truly > bad. Start with the SE and anti-SE med charts of Strum and others, then start Googling those meds. Some meds have obviously and non-debatably bad SEs, others are highly subject to personal choices, others just nuisances or even benign. > [Ron] prefers "life" over QOL. The alternative is not something most men > would choose. Studies of ADT SEs vs no (adjuvant) treatment cited here in the past show just the opposite. > I still don't know why you would prefer QOL over life It was explained ad nauseum last winter, and came down to one basic fact: the therapeutic index of early adjuvant ADT is very low. > you can't possibly know what ADT patients go thru because you don't take > it. You're talking emotionally; I'm talking large-population statistics. Apples'n'oranges. > Those who take it have something more precious....a few more years on this > planet. Cite even one study supporting that. > don't scare the hell out of newbies with your dire predictions!! They are not mine, and are not predictions. They are facts revealed by huge studies by highly regarded researchers. > Let them decide, in conjunction with their oncologist . . . Yeah, like THAT'S worked so well for the many people with poor doctors. Don't forget that 95% of doctors don't even mention osteoporosis to their PC pts. > if living is more important than possible side effects Show me where I've said any more than "do your research, examine your priorities, and choose for yourself. > And this . . . is called "balancing your views versus those of us who have > no choice". That's why I state and redefine the modifiers "early" and " adjuvant" over and over and over. They have very specific meanings your entire thrust ignores. I.P. On November 16, I. P. Freely responded to me, in pertinent part: > ........................................................................the anti-SE meds have their > own suite of SEs, which in turn need further meds with THEIR own SEs, ad > nauseum. There is, so far as I have seen, not a shred of evidence to support that statement. > Most people here revere Strum, so it's unclear to me what motivates Steve to > constantly reject Strum's work. I'm sure many of us would like to know why, > so we can make informed decisions on whether or when to doubt Strum. Cute, but it won't do. IP should read the section of the Strum and Pogliano book that addresses ADS (androgen deprivation syndrome) and what to do about it. He would find it instructive. Regards, Steve J "Steve Jordan" contradicts himself about Strum's ADS treatise. He both recommends and rejects it in this post alone, refuses to explain the conflict, and thus reinforces my admonition beautifully: do your own research, study your own priorities, and draw your own conclusions. > There is, so far as I have seen, not a shred of evidence to support that > statement. Straight from Strum's ADS treatise, the drug manufacturers, et.al.. Steve should STUDY the section of the Strum and Pogliano book that addresses ADS (androgen deprivation syndrome) and what to do about it. He would find it instructive. I.P. Yet another rant unsupported by any citations of evidence. I'll not do his research for him. What he does cite does not support his thesis. As I've said elsewhere, IP has quite evidently gone off the deep end. I'll waste no more time on this topic. It's useless and I have more interesting and important things to do. Regards, Steve J "A man's most valuable trait is a judicious sense of what not to believe." -- Euripides Ditto!! I get rather fed up with his rants on things he *personally* knows nothing about. All the studies in the world do not come anywhere near personal experience. Those that are on ADT thru no choice of their own certainly know more about the SE's than he does. And they are *quietly* dealing with them, mild or severe. Heather > Yet another rant unsupported by any citations of evidence. I'll not do his > research for him. [quoted text clipped - 11 lines] > "A man's most valuable trait is a judicious sense of what not to believe." > -- Euripides ditto the ditto > Ditto!! I get rather fed up with his rants on things he *personally* > knows nothing about. All the studies in the world do not come anywhere [quoted text clipped - 22 lines] >> believe." >> -- Euripides "Stavros Moschos" wrote. > ditto the ditto > [quoted text clipped - 5 lines] >> about the SE's than he does. And they are *quietly* dealing with them, >> mild or severe. >>> Yet another rant unsupported by any citations of evidence. I'm not surprised at Steve's and Heather's irrational comments, Stavros, but your gullibility surprises me. Do you also consider Strum, Walsh, Scardino, the ACS, the NIH, Mayo, Johns-Hopkins, and the countless equivalent sources I've quoted at length to be less reliable sources than Heather or Steve? Do you agree with Heather that Ron's SEs tell YOU more about YOUR SE expectations than the collective, analyzed experiences of 10,000 OTHER pts can tell you? Do you also not understand the oft-defined-here medical definition of the term "early adjuvant ADT", that "early" MEANS "pre-recurrence, PSA-free, symptom-free, and purely OPTIONAL", and NOT "thru no choice of their own "? Do you think dealing with SEs *quietly* is the best way, considering how many authors and pts alike plead with the medical field to get FAR more aggressive about emphasizing the entire slate of SEs and their large-scale statistical probabilities so fewer pts and doctors make uninformed treatment decisions (like the NINETY-FIVE PERCENT of ADT pts whose docs don't mention its virtually guaranteed, often crippling, and sometimes fatal SE: osteoporosis)? Is "quietly dealing with that" doing ANYONE a favor? Is Steve's denial of significant ADT SEs despite his admission that he has three of them which many people consider devastating, and his repudiation of Strum's ADS statistics, helping anyone make an informed ADT treatment choice? Must one have personally been in combat, survived Auschwitz, and/or borne a child to be qualified to comment on a war or a politician, to vote, or to favor one supreme court justice over another? If you can answer ANY, let alone more than one, of those questions with a "Yes", I'm surprised at you. It's your personal call, or course, but I can't let your support of such misinformation slip silently and unopposed into lurking newbies' minds. I.P. > I'm not surprised at Steve's and Heather's irrational comments, There is nothing *irrational* about our collective personal experiences on ADT....you have no *personal* knowledge on this topic. So yes, our experiences count for more than your oft-quoted studies. > Do you agree with Heather that Ron's SEs tell YOU more about YOUR SE > expectations than the collective, analyzed experiences of 10,000 OTHER pts > can tell you?<<< See above...... > Do you think dealing with SEs *quietly* is the best way, By *quietly*, I simply meant we don't rant and yell about things we are dealing with. You, OTOH.....do it all the time. However, you are not dealing with ADT SE's, so you cannot possibly know how we feel. Ergo, stop ranting and yelling about things you have not experienced. > (like the NINETY-FIVE PERCENT of ADT pts whose docs don't mention its > virtually guaranteed, often crippling, and sometimes fatal SE: > osteoporosis)? Back that one up with a valid citation.....and Ron had a bone density scan over a year ago, prior to starting ADT, and is on calcium and Vitamin D. Guess our doctor is one of the alleged FIVE PERCENT who knows about this. Stick to what you do best....which seems to be yelling at anyone who disagrees with you. Heather (and I am speaking on behalf of Ron when I say "we") A response to IP's latest rant. Give it up, Heather. There is no means of dealing reasonably with an hysteric. Especially one who plays fast and loose with the truth in order to make his points. Regards, Steve J "Facts are stubborn things; and whatever may be our wishes, our inclination, or the dictates of our passions, they cannot alter the state of facts and evidence." --John Adams > A response to IP's latest rant. > > Give it up, Heather. There is no means of dealing reasonably with an > hysteric. Especially one who plays fast and loose with the truth in order > to make his points. Yes.....you are right. He does have a habit of twisting things to suit his tirades. I think the regulars on here are well aware of that. Thanks.....Heather > Regards, > [quoted text clipped - 4 lines] > of facts and evidence." > --John Adams > "Steve wrote >> Give it up, Heather. There is no means of dealing reasonably with an [quoted text clipped - 3 lines] > Yes.....you are right. He does have a habit of twisting things to suit > his tirades. I think the regulars on here are well aware of that. Heather, Steve . . . I am very content to let the regulars 1. read the archives, 2. compare my body of relevant, cited, and impersonal PCa facts/statistics/opinions to your and Heather's ad hominem and deliberate word games, and 3. decide for themselves which sources (e.g. Strum vs Jordan) to weight most heavily in their decisions. Maybe you two could sway the newbies to your way of thinking if you'd show them from the archives what I have twisted or made up. Good luck. (God, but I LOVE this archived means of communication. It blows the false accusers out of the water SO easily.) I.P. > Heather, Steve . . . I am very content to let the regulars > 1. read the archives, Yes indeed, read the archives, something that I'm sure IP hopes folks will not do. > 2. compare my body of relevant, cited, and impersonal PCa > facts/statistics/opinions to your and Heather's ad hominem and deliberate > word games, and IP whines about ad hominem attacks, yet does not hesitate to attack my honor by calling me a liar. I will never, ever, forgive him for that. > 3. decide for themselves which sources (e.g. Strum vs Jordan) to weight most > heavily in their decisions. There is no such thing as "Strum vs Jordan." It is a figment of IP's overstressed imagination. IP has had numerous opportunities to PPOR (that's Provide Proof Or Retract, IP) but has failed to do so . Mainly because he cannot. > Maybe you two could sway the newbies to your way of thinking if you'd show > them from the archives what I have twisted or made up. Good luck. (God, but > I LOVE this archived means of communication. It blows the false accusers out > of the water SO easily.) IP has just shot himself in the foot. In addition to the slimy lie about my honor, he was caught lying on this very day by none other than Leonard Evans. IP carefully trimmed a sentence from Walsh's book so it would seem to support IP's position. Leonard rather more politely than he had to pointed out this dishonesty. See the thread, "New Member - Seeking Info." He makes charges against others and fails utterly to prove them. Whatever credibility IP ever had has been destroyed -- by IP himself. He has abdicated any claim he ever had to serious consideration of his views. Regards, Steve J "You can fool some of the people some of the time, and those are the ones you need to concentrate on." --Christopher Buckley > I.P. Wow. Let's see whether I can drag Steve's personal BS back into the realm of, say . . . prostate cancer. Maybe his browser dropped the term "PSA" in the thread topic. > IP whines about ad hominem attacks, yet does not hesitate to attack my > honor by calling me a liar. I will never, ever, forgive him for that. My attack was against your repeated, unsupported false claims about ADT SEs. Given the number of times and ways you've insinuated that I've lied, I thought it was time to quit beating around the euphemism bush so people trying to sort out the ADT issue could begin to separate information from misinformation. You invoke Strum's ADS treatise like the Holy Grail it may be, yet you: a) directly oppose his findings when I quote them verbatim or in general to put newbies back on track, b) refuse to explain why you oppose them so we can judge for ourselves, and c) claim I've not provided references despite their repeated and extensive presence in the archives. If you can provide evidence that Strum , et.al. are wrong or that I've misinterpreted them, that would be a much greater, more relevant, more credible, more enlightening, and less insulting-to-MY-honor approach than your baseless exaggerator, hyperbolator, pants on fire harrangue. Folks here want to be educated, stroked, or at least entertained, not misled and disgusted. Your personal claim of marginal ADT SEs (e.g., "I don't care", "mildly annoying", "normal") might sway a newby's decision unfairly if he didn't find your admission in the archives to three or more SEs that many patients in trials and here say made them avoid adjuvant ADT or abort it. Having to spend half of one's life in bed and the other half depressed and fatigued as Steve admits (and irritability is almost universal with androgen deprivation) is extremely regrettable, but it's not a normal result of PC, newbies; it's an OPTION common (***BUT NOT GUARANTEED***) with ADT, a CHOICE until all the other options are exhausted, and even then remains an option rejected by many people here and in many trials. Your inexplicable denial that anti-SE meds have their own SEs might confuse newbies who don't dig into the drug manufacturers' and pharmaceutical institutes' extensive analyses of SEs, counter-meds, and contraindications for those meds and counter-meds -- some quite serious and too common to ignore. Just look at the huge list of SEs rated "Frequent" -- some serious -- for your Zoloft during its trials. Telling newbies to research SEs, SE meds, SE med SEs, and on down the chain is useful and accurate; telling them they are avoidable can get ADT pts in dire straights and doctors justifiably sued. Lest a newbie think all this is just an academic, back-alley, pissing contest, consider this quote: "The biggest difference between adjuvant treatments is QOL, not survival; choose by SEs". (PCRI/Scholz, and reinforced by other authors) Wouldn't you feel horrible if some newbie actually believed your claim that he can avoid ADT-induced osteoporosis just by consulting an "up-to-date medic", only to find out while on ADT with five seconds of Googling that a) many millions of middle-aged men have very common conditions that preclude Fosamax and other O-mitigating drugs and b) a far greater percentage of doctors don't even discuss The Big O with their ADT pts? I have at least three contra-bone-med conditions, and most guys here have at least one. Unless newbies dig into the archives, they might actually believe your knowingly false charges that I've failed to provide extensive references, quotes, and even oncology board reviews of the ADT SEs I parrot from the literature. That would do a disservice to anyone trying to sort fact from fiction. Sorry if my more direct, accurate, unmistakable, and substantiated choice of words offended your honor, but I was getting nowhere presenting facts and would rather offend your honor than let you mislead some new PC patient into an abyss of unexpected SEs or even just one biggie he's not willing to tolerate. OTOH, I have zero sympathy for people who so readily choose personal assaults over rational discourse -- especially those who whine when they think the tables are turned -- so any extensive apology would be dishonest. Your honor will just have to suffer the same hit mine has . . . RGHT HERE, for example: > IP shot himself in the foot . . . was caught lying by . . . Leonard. IP > carefully trimmed a sentence from Walsh's book so it would seem to support > IP's position. Leonard . . . pointed out this dishonesty. See the thread, > "New Member - Seeking Info." Sorry, Steve, but my trimming was simply to avoid extensive quoting of a book most of us have at hand while reinforcing Leonard's statement that PC tx is indeed murky, as evidenced by differing professional opinions on various treatments. Leonard then expounded on the same theme by showing yet another apparent conflict within the same book and relating that to the biases of surgeons, brachytherapists, etc. My valid point was not whether seeds are optimal for the case in that thread; it was that that case is a good candidate for seeds in at least one expert's opinion . . . on that page. Thanks for your concern, but my foot's fine. No podiacide here, folks . . . move right along. Damn . . . if Idda known Leonard was dissin' me, I couldda got all insulted and like, but since he was talking CANCER and backin' it up with quotes, any implications went right over my head. Guess I'll have to start looking for insults in his stuff in the future. NOT! The REAL and much broader lesson to be taken from Leonard's comment is this: he discusses CANCER, not personalities. Since you often dwell on the latter, and I seem to be one of your preferred targets, and I can sit still in the face of OT unsubstantiated personal assaults only so long, and your ad hominem detracts so much from your GOOD contributions, I see no other solution other than to PLONK you. I'm going to miss your wisdom, but it's not worth having to wade through the personal pony crap to find the part relevant to this forum. If any masochists here want to see my two cents on your future posts, they know how to get my attention: it's called Cut & Paste. As the man says on the tee vee . . . You have the last word. Go. But no bloviating; that's my job. I.P. > you cannot possibly know how we feel. How you feel has absolutely zero relevance to cancer statistics. > Ergo, stop I'll stop calling BS on you when you stop telling gullible people that you know more about others' ADT prognosis than they can glean from the collective body of medical research. > ranting and yelling about things you have not experienced. Not that it matters, but I've experienced more ADT SEs than you have. >> (like the NINETY-FIVE PERCENT of ADT pts whose docs don't mention its >> virtually guaranteed, often crippling, and sometimes fatal SE: >> osteoporosis)? > > Back that one up with a valid citation I did. You ignore it because you get your "data" from Ron's case rather than the rest of the world. I.P. > "Stavros Moschos" wrote. >> ditto the ditto [quoted text clipped - 46 lines] > > I.P. It's precisely the "newbies" I am thinking of. It is doing them a great disservice to make them think that the SE's of ADT are as bad as advanced PCa. ADT will prolong that day, period. Or make them believe that doctors are all in a conspiracy to lure them into a treatment as bad as that. Or are ignorant. IP, with all due respect to you (I do believe that you mean well) I can only repeat what I said a number of months ago: sorry, but you are really dangerous. Gullible as you think I am. > It's precisely the "newbies" I am thinking of. It is doing them a great > disservice to make them think that the SE's of ADT are as bad as advanced > PCa. Never said it. > ADT will prolong that day, period. Never said otherwise. > Or make them believe that doctors are all in a conspiracy to lure them > into a treatment as bad as that. Never said it. > Or are ignorant. Straight from many authors, studies, and fellow a.s.c.p. members. > IP . . . but you are really dangerous. . I am sorry you consider data and direct quotes cited from Walsh, Strum, Scardino, Mayo, JH, S-K, JAMA, NEJM, ACS, NIH, J Urology, etc. to be dangerous, but it's your call. What is NOT your call is gross misrepresentation of what I have and have not said, but since the archives tell the real story, your distortions are moot. I.P. I think it depends on what the definition of "significant" is. I have been on the stuff for 2ΒΌ years. If I understand their positions, my SEs have met I.P.'s significance test. There are some aspects of the stuff that are a certified annoyance. But, I have also met Steve's test of significance in that I have yet required medication to counteract any SE (unless you count Fosomax, but that would fall within Steve's parameters as well). ... as I understand their positions. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA .07 .05 .06 .05 .08 non Illegitimi carborundum > On November 16, I. P. Freely wrote, in pertinent part: > [quoted text clipped - 50 lines] > > > > I.P. > ... > I'm not putting my life on hold for ANYTHING diapers or Tylenol will solve. [quoted text clipped - 3 lines] > if you abandon it. Who's more important . . . YOU, or your PC? > ... The issue that I.P. raises here really applies to all of life. As soon as we are old enough to know the facts of life, we learn that we will eventually die. Some people are paralyzed by that knowledge. Some escape into stories of an afterlife. Many of us just try not to think about it, and we succeed until some potentially fatal illness strikes us and we are forced to confront the unpleasant facts. My personal view is similar to I.P.s on this issue. We must not allow the inevitability of death to keep us from enjoying life. If PCa doesn't get us, something else will. There's no way to avoid it. So let's get on with life and enjoy what has been given to us rather than throwing it away in fear and depression. The worst thing that can happen is not that death terminates life, but that fear of death keeps us from ever living at all. Alan a whole raft of excellent points I'm saving for my first post-PSA-recurrence uro consult. I.P. > As soon as we are old enough to know the facts of life, we > learn that we will eventually die. Some people are paralyzed [quoted text clipped - 11 lines] > The worst thing that can happen is not that death terminates life, > but that fear of death keeps us from ever living at all. The afterlife is not an escape but a belief. Generally, at least for 80% of this country, it involves a belief in God. For most of those, it further involves a belief in Jesus Christ. It is not an escape. Having said that and taking that sentence from your post, I'd have to opine that truer words were never said. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA .07 .05 .06 .05 .08 non Illegitimi carborundum > ... > The afterlife is not an escape but a belief. Generally, at least for 80% of > this country, it involves a belief in God. For most of those, it further > involves a belief in Jesus Christ. It is not an escape. I apologize for the tone of my posting. I intend no disrespect to any who believe in an afterlife. I personally don't believe in it, but I respect the views of those who do. Alan > "Steve Kramer" wrote... >> ... [quoted text clipped - 6 lines] > to any who believe in an afterlife. I personally don't believe in it, > but I respect the views of those who do. I'll take it a step further: I hope they're right. I.P. I think I know you fairly well, Alan. I felt a need to comment on the sentence, actually on the whole post because it was wonderful post. But, upon reflection, knowing you meant no offense, I probably could have handled it like, "I'm sure you didn't mean...." Regardless, apology not needed, but accepted and no offense taken. It is unfortunate, however, IMHO, that you have no such belief. Personally, my belief was granite solid when I was a child, but shaken by the time I was 25 or so. Ironically (maybe not so ironic today), my faith was shaken by the very brothers and priests I was programmed to trust as a child. I lost my faith and was in a state of limbo, I guess, not really knowing what to believe. During those times, I was academically active and my pursuits were secular. But, I missed, I mean really missed, not having and participating in the faith. Then I read a book by R. Buchminister Fuller. He was a genius. Close, I think, to a Renaissance man. There are so many things I could attribute to him, not the least of which is the geodesic dome. But, one sentence, on one page... I can still see it in my mind.... bottom left... it says something like, "with all this order, there has to be a God or some being precipitating all this." So, I began my search anew. Much as I had been a student of the U.S. Constitution and realized the only way to learn the truth was by reading it and the Federalist Papers and then working forward, I realized that I needed to read the only book we have on God and see what it really says. I started with the premise that the Universe proves God exists. The Bible is the only documentation of Him and His direction. The Catholic Church, for me, did not exist yet because Christianity did not exist yet, because Jesus of Nazareth did not exist yet. Start in the beginning and work forward. I am redeveloping my faith. I am still not so sure the Catholic Church exists yet. Jesus was a wonderful man, but he is not yet born, so I do not yet know of his deity. I am not even yet certain that any but God and the angels exist in Heaven. I hope to have all the answers before I die. But, God has been proven to me. And that is good enough for now. I sleep better knowing. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA .07 .05 .06 .05 .08 non Illegitimi carborundum > > ... > > The afterlife is not an escape but a belief. Generally, at least for 80% of [quoted text clipped - 6 lines] > > Alan With all due respect from one who considers himself *Catholic* but who has always been perhaps too much of a liberal... there are *many* religions in the world that attempt to *culturally* define God and creation. While Jesus Christ is a centerpiece for those of us who consider ourselves Christian, I think we do a disservice to Jews, Muslims, Buddhists, and others to assume that there is only *one* way to understand God. Other cultures have a long history of faith. Personally, I think that all who believe .... and through *their* faith try to treat others as they would want to be treated... are on the same track, no matter what their *definition of God*. For those who do *not* believe, that is their right. I believe based on faith, not fact... and that is something each individual has to decide for himself. I went through a period similar to what you describe in my younger years, Steve. I was raised Southern Baptist... and converted to Catholicism in my thirties for personal reasons. From the time I was about 16 until that point in my mid-thirties, I was drifting ... with no real belief system to rely on. Are their flaws in the Catholic church? Of course, as the church is made of humans. But it's something that I can live with.... and it works for me. Obviously, it's dangerous to discuss religion and politics on an open forum... and I apologize in advance to anyone who may be bothered, angered, or hurt in any way by what I have written. Just sharing *my* thoughts.... and certainly respect the right of anyone else to share his/hers. Happy Thanksgiving to all! MikeH >I think I know you fairly well, Alan. I felt a need to comment on the > sentence, actually on the whole post because it was wonderful post. But, [quoted text clipped - 61 lines] >> >> Alan Well put Mike, many seem to have no tolerance of other religions. Peace can only begin with tolerance and acceptance. I work in an office with various faiths, an agnostic, a Jehovahs witness, Methodist(myself) and a born again Christian. Funny to say, the born agian Christian has the most trouble getting along with anybody else, to the point where our superiors have quit trying to get co-workers to work with him. Judge others by acts, not by the labels on their faith. Tom RRP 2002 Gleason 7 4+3, 90% of my biopsy samples positive for cancer cells last PSA .005 > With all due respect from one who considers himself *Catholic* but who has > always been perhaps too much of a liberal... there are *many* religions in [quoted text clipped - 103 lines] > >> > >> Alan If we judge others as we would hope to be judged ourselves (i.e., with love, mercy, and forgiveness), we'll be doing God's will, whether we have faith or not. In other words, don't judge anyone else at all, but instead .just deal with our own imperfectios > Judge others by acts, not by the labels on their faith. > > Tom > ... > If we judge others as we would hope to be judged ourselves (i.e., with love, mercy, and > forgiveness), we'll be doing God's will, whether we have faith or not. In other words, > don't judge anyone else at all, but instead .just deal with our own imperfections > ... What a wonderful view of religion you have Stavros. Something tells me you've thought a lot about all this. Regards, Alan >> don't judge anyone else at all That would make Dr. Laura's hackles rise. She says it's everyone's profound responsibility, even obligation, to judge others every day, lest we tolerate, even encourage, their bad behaviors and influence. If we don't judge our friends, baby-sitter, lawyer, doctor, potential mates, teachers, enemies, etc., frequently, and act on those judgments, we're letting any bad apples harm everyone they "rub off" on. IOW, we must not only judge others, but speak out against them when warranted. I wonder whether that very profound difference btw Stavros' and Laura's tenets are due to their religions, or to their own interpretations thereof? I support the judgmental approach, because isolationism fails at some point and letting people get away with bad behavior promotes escalation. Jesus' comment did not mean, "Don't judge"; it meant more like, "Don't be a hypocrite", as I've heard it explained. OTOH, being specifically told I'm going to hell because I don't join a specific religion makes me glad I'm not part of it, so there's such a thing as too much judgment. I.P. > >> don't judge anyone else at all > [quoted text clipped - 5 lines] > apples harm everyone they "rub off" on. IOW, we must not only judge others, > but speak out against them when warranted. I wonder if the actions you are choosing are decisions and not judgings. I recall a passage where Jesus told the apostles something like go into towns without anything and if they don't provide for you needs and listen to the word, leave and shake the dust from your feet. Whether I got the whole of it correct is not important. However, he was definitely telling them to pick and choose. I believe "judgment" requires an affirmative action to be taken against the person(s) being judged... hmmmm... maybe a passive action, too. If, as in Leviticus, you find someone's actions an abomination to the Lord, you are free to, depending on the era of the bible you are reading, kill that person. Now that is surely a judgment. But, the new Testament has, as I recall, a statement such as "judge not, lest you be judged." It might be that Laura is an Old Testament kind of gal and Stavros is New Testament. I believe Laura converted to Judaism from Catholicism. So that would make sense. > the new Testament has, as I > recall, a statement such as "judge not, lest you be judged." Which my comment and Dr. Laura address directly: "Jesus' comment did not mean, "Don't judge"; it meant more like, "Don't be a hypocrite", as I've heard it explained." I.P. >> the new Testament has, as I >> recall, a statement such as "judge not, lest you be judged." [quoted text clipped - 3 lines] > a > hypocrite", as I've heard it explained." When I get to that part, I'll read it within its context, but that sounds like a Clinton to me. > sounds like a Clinton to me. Nope. It's my vague recollection of Dr. Laura's simplified explanation, meaning that as long as we are willing to subject ourselves to the same standards, we surely can and should judge others. How ELSE do we choose among people than judge them? I.P. >> sounds like a Clinton to me. > > Nope. It's my vague recollection of Dr. Laura's simplified explanation, > meaning that as long as we are willing to subject ourselves to the same > standards, we surely can and should judge others. How ELSE do we choose > among people than judge them? So she's saying it's another "do unto others" deal? I don't know if I agree. I think He said, "Judge not". But, then I don't know what he said because I haven't researched it. And, now that you've reiterated your point, I guess you're right, at least in colloquialisms. "Good judge of character" comes to mind. "Good judgement" is another. But, I think Stavros (and I) was inferring a more active form of judgment. Regardless, we are getting way off the topic of PCa. I was intending to show how I deal with it and religion's role. Not so much as a stepping off point to debate all things religious. For some reason, my reply was not sent and was returned to me. Here it is again We have a semantic misunderstanding here. I was referring to moral judgements of others, not judging the losers of the spelling bee or judging in court whether someone has defrauded someone else or whether someone gives dangerous advice to others. Whatever our decisions are in such matters we should not condemn offenders as being inferior to ourselves. >>> don't judge anyone else at all > [quoted text clipped - 18 lines] > > I.P. > We have a semantic misunderstanding here. I was referring to moral > judgements of others, not judging the losers of the spelling bee or [quoted text clipped - 3 lines] > dangerous advice to others. Whatever our decisions are in such matters we > should not condemn offenders as being inferior to ourselves. You and I sure as heck are morally better than a thief or rapist or murderer or cheater, which makes them morally inferior to us, by definition. But that doesn't matter; inferiority and condemnation are just words, semantic or otherwise. What DOES matter is that people can and should make and often act on moral judgements every day to reduce the damage done to innocent people by immoral behavior. I.P. Can we look into the heart of anyone who does these things, or into the wounds and sufferings and torments and uncontrollable drives that have corrupted his soul and really know how I would be in the same circumstances? I can't. I can agree with his legal sentencing to deter others and possibly to rehabilitate him nut I cannot judge him. So we disagree. Let it go at that. >> We have a semantic misunderstanding here. I was referring to moral >> judgements of others, not judging the losers of the spelling bee or [quoted text clipped - 13 lines] > > I.P. > Can we look into the heart of anyone who does these things, or into the > wounds and sufferings and torments and uncontrollable drives that have > corrupted his soul and really know how I would be in the same > circumstances? I can't. I can agree with his legal sentencing to deter > others and possibly to rehabilitate him nut I cannot judge him. So we > disagree. Let it go at that. Please let me add another thought to the picture, because I think we're discussing, not arguing . . . I think your use of the term, "judgment" refers to a religious determination, as in whether a person should go to heaven or hell, in which case the person's torments matter. To me, "judgment" is a practical, here-and-now determination, as in "Is this person's behavior good (and I need a set of moral values to define "good") enough for me to let him affect my life?" That question couldn't care less WHY the person behaves as he does; that's between him and his god on Judgment Day, and ain't my problem. So, yes, the most obvious difference goes back to our definitions of the word, "judgment". I.P. Whew! Look what I started! Thanks for all the info, I'm taking things one at a time but I like to sketch out my decision tree so I can "be prepared" (being an Eagle Scout). No sure I want to get into religious dogma, although juding others goes far beyond a religious idiom. Someday when I have lots f otime I'll regale ya with my religious treatise, as religion does have some bearing on the basic subject at hand (PCa). Meanwhile I'll continue to eagerly turn these pages... >> Can we look into the heart of anyone who does these things, or into the >> wounds and sufferings and torments and uncontrollable drives that have [quoted text clipped - 15 lines] > > I.P. I. e., What a low-lying rotten creature he is for [insert something really bad]. I sure am glad I'm not like him. I will shun him and have nothing to do with him OR, Poor guy, I wonder what made him do that? I know I've done some bad stuff in my life that sure bothered me. If I can help him or maybe say a sympathetic word to him, I will. > Poor guy, I wonder what made him do that? I know I've done some bad > stuff in my life that sure bothered me. If I can help him or maybe say a > sympathetic word to him, I will. But will you let him date your 15-y-o daughter, house-sit while you're on vacation, or manage your investments? I.P. >> Poor guy, I wonder what made him do that? I know I've done some bad >> stuff in my life that sure bothered me. If I can help him or maybe say a [quoted text clipped - 4 lines] > > I.P. none of the above >> But will you let him date your 15-y-o daughter, house-sit while you're on >> vacation, or manage your investments? > none of the above There ya go. You've judged him and acted on it. Atta boy! Now whether you call the police, get him into counseling, pray for his redemption or for his condemnation to hell, warn everyone to shun him, and/or put sugar in his gas tank is between you and your conscience and your god, but at least you've handled the practical, real life side of the issue. I.P. . Well, I don't have a fifteen year old daughter, never go on vacation, and have no investments. So are we deadlocked? >>> But will you let him date your 15-y-o daughter, house-sit while you're >>> on vacation, or manage your investments? [quoted text clipped - 10 lines] > > I.P. . > "I. P. uttered >> But will you let him date your 15-y-o daughter, house-sit while you're on >> vacation, or manage your investments? And Stavros, he went like >>> none of the above >>> But I don't have a fifteen year old daughter, never go on vacation, and > have no investments. So are we deadlocked? Just the opposite; it sounds like we agree on the principle of judging people at the practical level. But even if we didn't, "deadlocked" means to me that neither can change the other's mind, and that wasn't our intent. I was just trying to better understand this business of not judging people, and you sounded like someone who had given it a lot of thought. I.P. No, that wasn't our intent. You and I are square. But right now I am facing a reinstallation of my Windows XP, a frightening task indeed, so we may have to end our discussion. Actually, we have. But something else will pop up. >> "I. P. uttered > [quoted text clipped - 15 lines] > > I.P. > I am facing a reinstallation of my Windows XP, a frightening task indeed I just hope it helps you more and longer than it helped me. It's the Customer Service mantra, their substitute for actually FIXING THE PROBLEM, and I've gained little benefit from it. Even with a second HD on my computer so I could just format one HD and keep on truckin' on the other, and had Dell on the line the whole time plus Microsoft part of the time, it took us six hours and may have done as much harm as good. At least it freezes less often now. I.P. OK, I enjoy the give and take on these topics BUT... as is often said... ''Never discuss religion or politics". Well...when I was younger.., as a lark, I 'bought' a Reverend's License' from the ULC...Universal Life Church...online, which would allow you to perform weddings, funerals, etc. I think that $5 was the fee then. (They're still online) The point though was that the church's credo was to "Do what is right" Sounded good to me. Sorta like 'do the right thing.' That's what I try to do. Judge, don't judge, just do what is right. We all pretty much know what that means. So...that's how I try to live. I wish I could believe in a higher being, but it's hard. I wish I could believe in an afterlife, but it too is hard. But doing the right thing...well...that seems OK. So...that's what I try to do. I've lost my 'card'...so I won't be doing any weddings, :-) but I'll still try to do the right thing. To all of you wonderful folks who have helped me greatly... My very best wishes for your health and a pleasant holiday. Ron Burton Chicago "Ron B" wrote> > The point though was that the church's credo was to > "Do what is right" > Sounded good to me. Ask your grandkids what it means. Odds are s/he'll say something like this: 1. Oral sex is second base, and is not sex. 2. Cheating (tests, resumes, ANYTHING) is necessary and OK because everybody does it. 3. Pot is OK and should be legalized. 4. "But, Granddad, it's just my belly button and a little asscrack. I am NOT a slut just because my thong shows!" (I hope that was your grandDAUGHTER.) 5. The government owes me a job, a wage I can raise a family on, free college, free health care, a cell phone, and cheap gas. 6. And Daddy owes me a car at 16. I.P. An interesting point of view. I would add to it, if you don't mind.... In reading the Bible, I note most prominent among the stories of the Old Testament is the idea that mankind, or at least His chosen people, fluctuate back and forth in their behavior. I cannot count (though someone probably has) the number of times they progress toward monotheism, then back again, or to nothing at all... or ... how they progress in behavior and debauchery and sometimes technology and regress back to a certain state. Regardless of the existence of a Supreme Being, or the presence of one, or the actions of one, mankind should strive to continuously improve their behavior with each other... they should strive to do what is right more often than the last generation and to do what is wrong less than the last. Take away the political and religious ramifications and I think everyone would agree that debauchery is not a good thing, nor is premarital sex, nor is abortion. And, before the conservatives here (count me among them) cheer, nor is fighting or war. We might still have some debate over issues of homosexuality, eating meat, government-controlled welfare, etc., but I think that given time and energy without unnecessary outside influences, a vast majority of people could agree on some precepts... Ha! It just dawned on me that it may look like the last 7 Commandments. In any case, to echo Ron, here's wishing y'all a very Happy Thanksgiving. Regardless of your religion, country, politics, etc., I hope you all go get stuffed! > OK, I enjoy the give and take on these topics BUT... > [quoted text clipped - 43 lines] > > Chicago Oy Vey. I really love and respect ALL of you in this group. The debates about ANYTHING give me hope that you still have strong spirits. I.P. mentioned: "Where do we draw that line? Months of screaming, intractable pain wiping out every other thought? Years of total dementia with Alzheimers? Terri Schiavo?" As a scared, depressed and anxious patient... that is probably what I fear the most. As a druggist...I also feel that drugs would be able to combat this to some extent. I HAVE no family...so the 'being alone' factor is always a concern. Rather than argue the treatments...I just read them and try to grasp bits and pieces that might help me. There are many. Keep going. I wish you all the very best of health and a decent Thanksgiving. Keep on keepin' on. (a blast from the 70's) :-) Stay feisty, say what's on your mind...and in the process...you help us all. Best of everything, Ron B. Chicago > I HAVE no family...so the 'being alone' factor is always a concern. > I am a druggist. Then you have a greater threat, a greater freedom, and a rarer opportunity for inner peace than most of us do. Greater threat, because you MAY have more threat of being alone. I emphasize "may" because some families suck and most friends don't. My family, beyond my wife, are thousands of miles away. My friends are thus more likely to hold my hand than any family except my wife. Start cultivating some good, close, RETIRED friends . . . and realize they may need you first. Greater freedom, because you have only yourself to consider when the mets hit the fan. Those with (worthwhile) family must make an earth-shaking, gut-wrenching decision: WHEN to end the pain -- regardless of whether it's by MORE morphine or WAY TOO MUCH morphine. With no close family to consider, both when and how should be much simpler decisions. The rare opportunity? You're a druggist, man; do I have to spell it out? '-) You can just pop some pills whenever YOU decide it beats NOT popping those pills. THAT, my friend, is freedom, even if you CHOOSE to wait even longer than any good Mormon (BIIIIIIG family!) would or CHOOSE to let nature take its course. CHOICE is vital to peace of mind, as self-medicated post-op patients prove every day. I've got to determine the right drug, then obtain it without incriminating my family, then find a way to keep it nearby when whisked off to a hospital, then hope to hell I can successfully walk the line between taking it before my wife is ready vs waiting too late to have the physical and mental capacity to choose and implement a timely ending. I plan to define my end-point criteria while I'm still sharp, so my decision process is not clouded by drug-induced dementia. Cancer may shorten my life, but I'll be damned if I'm going to let it KILL me any old way it wants. I will not be a (complete) victim of this beast! Now . . . how does one bypass the dosage limiter on those self-administered morphine drip towers . . . I.P. > I am of course concerned.... concerned enough to put off making winter > vacation reservations until after the PSA test for fear that readings > above 0.1 would trigger further regular tests and prep for EBRT (and of > course my max out-of-pocket resets Jan 1). > Can anyone here comment on the "PSA noise" issue, and/or on my diatribe > regarding post LRP treatment? Pops. Make your plans! You had one bad reading and that reading wasn't high enough to start EBRT. You're about due for another PSA. If it is another 0.25, you're still going to wait until February or so for another PSA before starting treatment. Right now, you're pushing off your plans for fear of something that might happen. That borders on a phobia. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA .07 .05 .06 .05 .08 non Illegitimi carborundum > I've also quietly watched developments in this NG regarding the use of > hormonal therapies. It is my understanding that the only possible [quoted text clipped - 6 lines] > to have worked, I will wait until the last possible monent before > Invoking HT, if at all. My ruminations: Normal cells live and die, normal cells duplicate to replace the missing/dead. Cancer cells differ in that their genes are mutated. The first thing we can say from this is "anything goes, now". Most mutations are never heard from, they're non-viable and die before they can *think* of reproducing. Other mutations stay within "the limits" that normal tissue stays within, and thus never shows up anywhere (the freak-a-zoid acts normal). "cancer" is when the mutation is not immediately lethal, reproduces faster than it dies, and doesn't obey the normal limits. Enter "PCa". Normally PCa cells require Testosterone to function. Without it they go dormant. This means that they stop reproducing. Take T'one away from PCa cells, and one of the characteristics of "cancer" is gone, they're not reproducing faster than they're dying. Since they're mutants, they'll eventually die. Keep up the ADT for 3 years, and you may find the cancer gone without other actions. So, if you're doing seeds (LDR or HDR, it doesn't matter), and EBRT of some kind, doesn't matter, adding Casodex then Lupron to the mix is starving the little bastards while the radonc's shoot them. (Lupron causes a T'one *surge* before the T'one level drops to nadir. This is giving the little bastards a "last meal". Casodex is a T'one uptake inhibitor, taping the little bastards mouths shut just before serving the "last meal" Lurpon's manufacturer recommends Casodex (by effect not name) before starting Lurpon.) > Keep up the ADT for 3 years, and you may find the > cancer gone without other actions. Sorry, ADT does not cure PCa. Sooner or later non hormone dependent ("hormone refractory") cancer cells will multiply regardless of ADT. When used with the right timing, what ADT can do is prevent hormone dependent cells from killing you sooner than the hormone refractory cells do. Exactly what that right timing is is unclear. There seems to be a trend amongst some doctors towards delaying ADT until the hormone dependent cancer has reached a point where it might cause symptoms. As Leonard points out, it is not known whether this increases the rate of development of hormone refractory cancer due to continued mutation from hormone dependent cancer cells. Some people see low but rising PSA and go to early ADT for reasons that are not based on any clear science. That doesn't mean that they are wrong; if they can deal with the side effects, you might consider them as erring on the cautious side. SignaturePeter Headland > There are a lot of people posting here regarding PSA levels with > resolutions equal to or less than 0.01. [quoted text clipped - 45 lines] > to have worked, I will wait until the last possible monent before > Invoking HT, if at all. I'm not sure anyone really understands just how hormone resistant cancer develops. But the conventional theory, which does have some support, is that the hormone resistant cells are there from the beginning, and their growth rate is not affected by the use of hormone therapy. Also, I don't believe that hormone therapy is supposed to have a 'half-life' in the sense that it works for some period of time after it is started. According to the theory, it works on hormone dependent cells any time, and delaying its use doesn't decrease its effectiveness on those cells. So the conclusion, if you accept the theory, is to begin hormone therapy when there is danger of that part of the prostate cancer producing symptoms. But of course, if in fact, hormone dependent cells regularly mutate into hormone independent cells, it would be another matter. > Can anyone here comment on the "PSA noise" issue, and/or on my diatribe > regarding post LRP treatment? > > To all of you, who have |
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